Functional improvement with the Sever L'Episcopo procedure

This was a prospective study to determine the functional results in patients with obstetric palsy treated with the Sever L'Episcopo procedure using a simple five-grade scale consisting of the ability to reach the abdomen (grade 0), upper thorax (grade I), mouth (grade II), forehead (grade III), and occiput (grade IV), which translates into an improvement in basic daily activities. Forty-nine procedures were done in 48 patients (one bilateral) with a preoperative and postoperative evaluation of each case. Range of motion was also recorded for each patient both preoperatively and postoperatively. The overall results showed an improvement of two grades in 61% of our patients. The improvement in range of motion averaged 64 degrees for active abduction and 42 degrees for active external rotation. Functional goals must be the principal concern. With this method of evaluation, we can measure (in a simple way) improvement in the activities of daily living.